Posted Date : February 13,2020
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : PHAR-0369
Government Authority located in Jackson, Mississippi; USA based organization looking for expert vendor for pharmacy benefit manager services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide pharmacy benefit manager services including network pharmaceutical pricing through financial arrangements with pharmacies, pharmacy network provided by the PBM must contain a sufficient number of pharmacies to provide to all participants adequate access, in-state as well as out-of-state, as determined cooperatively by the PBM and the board to the government authority located in Jackson, MS.
- Pharmacy network will provide the Plan with a cost-effective network of pharmacies contracted at rates that are commensurate with the size of the Plan and its associated purchasing power.
- PBM will provide clinical programs cost containment such as prior authorization, step therapy and specialty drug management, and a mail order distribution channel.
- Prescription drug benefit management services to the state and school employees’ health insurance plan.
- Plan’s health insurance component is a self-insured, non-ERISA health insurance plan, currently providing health insurance coverage to approximately 195,000 participants. Eligible participants in the Plan include active, retired, and COBRA employees (and their enrolled dependents) of the State’s agencies, universities, community/junior colleges, school districts, and public library systems.
- PBM must employ and assign a dedicated and exclusive clinical pharmacist to advise, consult, and participate in activities relative to all aspects of the contract between the Board and the PBM.
- PBM must provide consultative services regarding pharmacy benefit design including, but not limited to, formularies, allowable charges, generic drug incentives, implementation of programs which control utilization and optimize health, utilization review services, and evaluation of drug use and cost data.
- PBM’s claims processing services must include, at a minimum, verification of eligibility, review of claims in accordance with the Plan benefits, receipt, processing, adjustment, and authorization of claim payments, provision of claim forms, and provision of explanation of benefit (EOB) forms for paper claims.
- PBM must adjudicate all claims according to “lowest of” logic such that members and the Plan pay the lowest cost of the contracted price or the pharmacy’s usual and customary amount.
(2) A mandatory notice of intent to bid due on March 5, 2020.
(3) All question must be submitted no later than March 5, 2020.
[C] Eligibility:
- Onshore (USA Only);
[D] Work Performance:
Performance of the work will be Offsite. Vendor needs to carry work in their office location
Budget :
Deadline to Submit Proposals: April 07,2020
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
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Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : PHAR-0369
Government Authority located in Jackson, Mississippi; USA based organization looking for expert vendor for pharmacy benefit manager services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide pharmacy benefit manager services including network pharmaceutical pricing through financial arrangements with pharmacies, pharmacy network provided by the PBM must contain a sufficient number of pharmacies to provide to all participants adequate access, in-state as well as out-of-state, as determined cooperatively by the PBM and the board to the government authority located in Jackson, MS.
- Pharmacy network will provide the Plan with a cost-effective network of pharmacies contracted at rates that are commensurate with the size of the Plan and its associated purchasing power.
- PBM will provide clinical programs cost containment such as prior authorization, step therapy and specialty drug management, and a mail order distribution channel.
- Prescription drug benefit management services to the state and school employees’ health insurance plan.
- Plan’s health insurance component is a self-insured, non-ERISA health insurance plan, currently providing health insurance coverage to approximately 195,000 participants. Eligible participants in the Plan include active, retired, and COBRA employees (and their enrolled dependents) of the State’s agencies, universities, community/junior colleges, school districts, and public library systems.
- PBM must employ and assign a dedicated and exclusive clinical pharmacist to advise, consult, and participate in activities relative to all aspects of the contract between the Board and the PBM.
- PBM must provide consultative services regarding pharmacy benefit design including, but not limited to, formularies, allowable charges, generic drug incentives, implementation of programs which control utilization and optimize health, utilization review services, and evaluation of drug use and cost data.
- PBM’s claims processing services must include, at a minimum, verification of eligibility, review of claims in accordance with the Plan benefits, receipt, processing, adjustment, and authorization of claim payments, provision of claim forms, and provision of explanation of benefit (EOB) forms for paper claims.
- PBM must adjudicate all claims according to “lowest of” logic such that members and the Plan pay the lowest cost of the contracted price or the pharmacy’s usual and customary amount.
(2) A mandatory notice of intent to bid due on March 5, 2020.
(3) All question must be submitted no later than March 5, 2020.
[C] Eligibility:
- Onshore (USA Only);
[D] Work Performance:
Performance of the work will be Offsite. Vendor needs to carry work in their office location
Budget :
Deadline to Submit Proposals: April 07,2020
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$